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Dialysis patients' preferences for family-based advance care planning
S C Hines1, J J Glover, J L Holley
1West Virginia University, Morgantown 26506-9022, USA.
Background:
Most patients do not participate in advance care planning with physicians.
Objective:
To examine patients' preferences for involving their physicians and families in advance care planning.
Design:
Face-to-face interviews with randomly selected patients.
Setting:
Community-based dialysis units in one rural and one urban region.
Participants:
400 hemodialysis patients.
Measurements:
Questions about whom patients involve in advance care planning, whom patients would like to include in this planning, and patients' reactions to state legislation on surrogate decision makers in end-of-life care.
Results:
Patients more frequently discussed preferences for end-of-life care with family members than with physicians (50% compared with 6%; P < 0.001). More patients wanted to include family members in future discussions of advance care planning than wanted to include physicians (91% compared with 36%; P < 0.001). Patients were most comfortable with legislation that granted their family end-of-life decision-making authority in the event of their own incapacity (P < 0.001).
Conclusion:
Most patients want to include their families more than their physicians in advance care planning.
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